Experts make hepatitis B recommendations for children

An expert panel of pediatric liver specialists was recently called by the Hepatitis B Foundation to formulate the first national recommendations for the treatment of children with chronic hepatitis B virus infections.

The results of their findings were published on October 1 in the online journal Hepatology. The group first met in November 2008. Their initial recommendations for the screening and monitoring of chronically infected children with hepatitis B virus were published in the journal Pediatrics around that time. They met again in 2009 to discuss the challenges of conducting antiviral treatments with children, but this is the first time they have issued national recommendations.

"There is an urgent need for specific guidance in the management and treatment of children living with chronic HBV infections," Joan Block, executive director of the Hepatitis B Foundation, said. "Currently, there is a significant gap in knowledge among most pediatricians, and even among many pediatric specialists, in the appropriate care and management of these children."

Children with chronic hepatitis B have few therapeutic options. The U.S. Food and Drug Administration has has only approved four out of the seven available hepatitis B antiviral medications for children, and only two of those are approved for use in those under the age of 12.

In addition, unnecessary use of nucleostide analog antiviral drugs can lead to drug resistant strains. This can impact the treatment options for an individual later in life and lead to a public health threat.

"There is still much to be elucidated about the appropriate use of HBV therapy in children," Brian McMahon, of the Alaska Native Tribal Health Consortium, said. "It is important to identify children with chronic HBV infection through screening, monitor them closely, and treat if appropriate, but until more clinical data and therapeutic options are available, a conservative approach is warranted."